Tamara is 38 years old and a general practitioner. Tamara also conducts research into infectious diseases at the UMC Utrecht and is involved in the regional healthcare network for antibiotic resistance and infection prevention.
Everyone will encounter an infectious disease at some point in their lives, such as a cold or a bladder infection. This usually poses a minor problem. But if it cannot be treated properly, the impact can be very significant.
In search for the right drug at her work, Tamara deals with the consequences of antibiotic resistance. “Sometimes my patients’ complaints are not even very severe, but drastic treatment is still needed.
For example, I recently referred a young woman to the hospital with a bladder infection. Despite her mild complaints and relatively good health, she had to be admitted for IV therapy for a week because the regular antibiotics did not work.”
The cause of the infection often isn´t clear which makes treating the infection difficult. “Doctors often do not immediately take a blood culture of patients to investigate the infection. Preference is therefore usually given to an antibiotic that combats the most common disease-causing bacteria.
But we are increasingly seeing that certain bacteria groups are resistant to this type, which means we have to use alternative resources.”
Looking at the figures, it appears that Dutch healthcare is less affected by antibiotic resistance than healthcare in other countries.
(1) This is partly because Dutch doctors are relatively cautious in prescribing antibiotics.
Yet Tamara sees room for improvement. “Prescribing behavior varies greatly per doctor. For example, they are more inclined to prescribe a treatment when a patient visits often or when the workload is very high.”
Despite the risks of side effects and resistance, antibiotics are still considered safe, fast-acting and widely applicable medicines. As a result, patients often request antibiotic treatment themselves.
Social pressure also plays a role. “Nowadays we are not very good at being sick. My patients seem to worry more quickly about regular health complaints and experience a lot of external pressure to get better quickly.”
It is important that the doctor and the patient talk to each other. “For example, after a conversation it may turn out that a course of antibiotics is not necessary. However, preventing infectious diseases remains complicated.
“With the corona pandemic, we ended up in a living experiment where we could see that keeping distance and strict hygiene measures help prevent the spread of disease-causing viruses and bacteria. But the measures were burdensome for healthcare and society.
” Prescribing antibiotics plays a major role in preventing antibiotic resistance. “However, there must be a strong intrinsic motivation to properly implement infection prevention measures, because we do not receive an automatic error message if things go wrong.”
(1) Within Europe there are large differences between countries in the prevalence of antibiotic resistance. In Northern European countries, resistance rates are generally lower than in Southern and South eastern European countries (Source: VZinfo 2023). The extent of antibiotic use and the quality of infection prevention in hospitals and long-term care institutions are factors that play a role in this.